An Arm and a Leg .Managing human services expenses Managing interminable ailment An Australian private wellbeing safety.


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An Arm and a Leg….Managing healthcare costs Managing chronic disease- An Australian private health insurer’s perspective. Julie Andrews Group Manager, Health Services Medibank Private May 2007. State of the private health industry…. The Australian Care Health Environment.
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An Arm and a Leg… .Managing social insurance costs Managing endless ailment An Australian private wellbeing safety net provider\'s viewpoint Julie Andrews Group Manager, Health Services Medibank Private May 2007

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State of the private wellbeing industry… . The Australian Care Health Environment

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The Australian Health Care Environment Public and Private frameworks Universal Health Care System-Medicare Complementary private wellbeing framework: 33% of beds 39% of all confirmations: 56% of surgery Private health care coverage: Value recommendation: decision and get to Hospital (inpatient care) and Ancillary spreads Consumer advertised, with various motivating forces Community rating Portability Over 10 million individuals safeguarded (most astounding in 20 years) Hospital cover: 8.90 million (43.2%) 65 yrs+ : 45.7% guaranteed yet just 13.3% of the populace

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Chemotherapy 53% Major techniques for threatening bosom conditions 54% Hip Replacements 55% Other real joint substitution & appendage reattachment 63% Mental wellbeing treatment, same day 65% Major focal point methods 70% Major wrist, hand & thumb methodology 71% Knee strategies 77% The Australian Health Care Environment Public and Private frameworks Proportion of strategies performed in Private Hospitals

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The Australian Health Care Environment Healthcare consumption development

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State of the private wellbeing industry… . Effect of Chronic Disease… and Arm and a Leg

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Chronic Disease and High Cost Claims 1% of Membership is in charge of 45% of doctor\'s facility expenses MPL Claims information

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Chronic Disease and Avoidable Admissions Top 5 Avoidable affirmations by condition AIHW 2006

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Chronic Disease and Risk Factors Contribution of preventable Risk elements to Burden of Disease AIHW: 2006 Australia\'s Health 2006

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Relationship between Health Risk and Costs

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State of the private wellbeing industry… . Malady Management: the Private Health Insurance Experience

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Medibank\'s Disease Management Journey 2006-2007 2003-2005 From 2000-2002 Member Wellbeing Pilots researching modified wellbeing data; Personalized exhortation & criticism; Interactive projects, telephonic and online support; GP engagement Peak Health Alliances Health Information & Health Promotion (general gathering of people, not focused on) National Heart Foundation National Asthma Council DepressioNet better wellbeing Programs Telephone and mail based illness administration and case administration programs focusing on individuals with particular wellbeing conditions and various co-morbidities Face to face case administration administrations Online wellbeing data and wellbeing programs concentrating on wellbeing dangers, for example, being overweight, eating regimen and absence of physical practice Objective : To decrease the effect of wellbeing danger and infection on our individuals and impact future medicinal services usage and expenses. Goal: To adjust Medibank to wellbeing data and counsel in the psyches of our partners. Goal: To evaluate effect of pilots on individuals\' wellbeing status, to enhance inner ability & learning.

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Medibank\'s Disease Management Programs better wellbeing Online Web-based individual Wellness Record bolstered by Active Health projects and data for individuals with wellbeing dangers better wellbeing On Track Diabetes Mail based diabetes observing system for individuals with sort 2 diabetes advancing deterrent care and enhanced self administration better wellbeing On Call Telephone-based, proactive bolster programs giving patient instruction and self administration for individuals with endless malady Interventions in light of Australian rules and best practice and got from Australian information, eg Burden of Disease Guided by consultants: GP, Disease Management authority, disease transmission specialist Programs subjected to a free 3 rd party assessment

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better wellbeing web based Promoting prosperity & avoidance

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Medibank\'s Disease Management Programs better wellbeing Online Web-based individual Wellness Record upheld by Active Health projects and data for individuals with wellbeing dangers better wellbeing On Track Diabetes Mail based diabetes checking program for individuals with sort 2 diabetes advancing precaution mind and enhanced self administration better wellbeing On Call Telephone-based, proactive bolster programs giving patient training and self administration for individuals with perpetual illness Interventions in view of Australian rules and best practice and got from Australian information, eg Burden of Disease Guided by counsels: GP, Disease Management master, disease transmission expert Programs subjected to an autonomous 3 rd party assessment

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better wellbeing On Track Diabetes Program Objectives: Improve member\'s learning of diabetes administration and inconveniences screening Increase rates of complexities screening and hazard figure appraisal Increase the extent of individuals meeting treatment targets Components: Survey Mailed individualized criticism and proposals in view of pathology results Information tip sheets

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Medibank\'s Disease Management Programs better wellbeing Online Web-based individual Wellness Record bolstered by Active Health projects and data for individuals with wellbeing dangers better wellbeing On Track Diabetes Mail based diabetes checking program for individuals with sort 2 diabetes advancing safeguard mind and enhanced self administration better wellbeing On Call Telephone-based, proactive bolster programs giving patient instruction and self administration for individuals with ceaseless ailment Interventions in view of Australian rules and best practice and got from Australian information, eg Burden of Disease Guided by counselors: GP, Disease Management pro, disease transmission expert Programs subjected to an autonomous 3 rd party assessment

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better wellbeing On Call Program Target conditions: CAD, CHF, COPD Objectives: Improve member\'s information and administration of his/her condition(s) Improve consistence with rules and targets Components: Outbound calls from wellbeing experts Development of Action Plans/Care Plan predictable with GP mind Mailed data 24 hour call line

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State of the private wellbeing industry… . The Bottom Line… … consequences of Medibank\'s Disease Management Programs

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The Results: Change in Health Status HRA and Health Risk Programs 32% recorded a normal diminishing of 1.5kg/m2 in BMI with a normal weight reduction of 4.6 kg Females under 25 and guys more than 55 recorded the biggest normal upgrades in BMI 28% announced a normal increment in physical action from 103 to 204 minutes for every week (97% expansion) Improvements in Blood Pressure, Blood Glucose and Cholesterol (High>Normal; Normal>Low; Not sure> Aware) were accounted for in approx 5% of members Only somewhat over 1% quit smoking and 5% lessened their liquor consumption

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The Results: Change in Health Status HRA and Health Programs

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The Results: Change in Health Status Diabetes On Track Pilot Members at most astounding danger, with results outside the objective extents for CVD hazard variables, had the best enhancements which included: Nearly 70% of those with beginning high blood glucose (HbA1c) level demonstrated change Close to 10% of members accomplished a 1% point diminish in their HbA1c 35% achieved focus for aggregate cholesterol a 14% change from standard general blood lipid levels enhanced by 8% 39% brought down systolic BP-26% accomplished 10mmHg decrease half revealed an expansion in physical movement 56% of the individuals who were overweight or corpulent shed pounds

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The Results: Change in Health Status Diabetes On Track Pilot

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The Results: Change in Behavior Diabetes On Track Pilot Foot checks expanded , with >50% happening in the period promptly after the study mail-out 33% detailed changes in their cooperation with their GP "I turned out to be more decisive – requesting HbA1c" 25% revealed initiating BP prescription; 25% began cholesterol drug; half altered Diabetes treatment 80% increment their insight about diabetes HRA and Health Programs Member Wellbeing members revealed expanded GP visits (24%), especially those in hazard programs (31%)

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The Results: Change in Behavior better wellbeing On Call Programs - Preliminary Results Over 2,000 individuals are at present taking an interest in better wellbeing On Call As at Dec-06, 520 had finished six-months on the Program, with 193 on COPD program, 275 (CHF) and 52 (CAD) Key enhancements in these individuals were: Daily weighing up from 34% to 72% (CHF) Low sodium abstain from food for 86% from 60% (CHF) Early acknowledgment of side effects up from 56% to 77% (COPD) Uptake of composed activity arranges (COPD: 13%  52%, CHF: 3% 43%) Increased familiarity with circulatory strain (CAD: 57%73%) Lower normal BMI (CAD: 26.926.5)

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The Results: Change in Utilization Diabetes On Track Pilot For the 295 members who finished the program, doctor\'s facility affirmations lessened by 16% in the 12-month pilot when contrasted and the past 12-months Includes 8% diminish in overnight confirmations MPL information shows that diabetes as a co-horribleness duplicates the cost of a clinic affirmation 8% decrease in advantages paid to 295 last members amid the pilot contrasted with the earlier 12-months Largely determined by 9% diminish in doctor\'s facility benefits More medicinal/indicative DRG\'s as opposed to surgical DRG\'s

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The Results: Change in Utilization Member Wellbeing Pilot

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The outcomes: Change in part..

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The inquiries remain: Are we making the best choice? Redress focusing on Optimizing cooperation Intervention adequacy Cause and impact? Will we acquire the advantages? Maintaining conduct change Delivering positive ROI

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Contact Details: Julie Andrews Group Manager, Health Services Medibank Private Level 16, 700 Docklands Vic 3008 Phone: (03) 8622 5240 Fax:

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